The biliary system is a complex network of microscopic and macroscopic structures involved in the formation of bile, an aqueous fluid in which a considerable amount of otherwise immiscible cholesterol is transported by other lipids such as bile acids and phospholipids. This book summarizes current understanding of the molecular and cellular mechanisms of cholesterol and bile acid metabolism, as well as the physical-chemistry of biliary lipids, with an emphasis on biliary lipid metabolism that is regulated by nuclear receptors in the hepatobiliary system.

By guiding readers through the various aspects of anatomy, physiology, and biochemistry of all "players" involved in bile formation, this book is intended to be a manageable, easy-to-study compendium of recent progresses in understanding the molecular mechanisms of cholesterol and bile acid metabolism. The authors clearly explain the molecular and cellular pathways that regulate hepatic lipid metabolism, and present color figures, tables, and flowcharts that explain the fundamental mechanisms of lipid synthesis and secretion, bile formation, the enterohepatic circulation, and intestinal absorption of biliary components. Moreover, the consequences of the complex events involving lipid metabolism in the hepatobiliary system are reviewed, with a focus on the translational value of current basic research in health and disease.

The revised 2nd edition of this book has been enriched with multiple figures further detailing the metabolic pathways of lipids, updated evidence elucidating lipid metabolism in the liver and biliary system, and updated authoritative bibliographies for each chapter.

About the Author(s)

David Q.-H. Wang, Saint Louis University School of MedicineDr. David Q.-H. Wang is a Professor of Internal Medicine, Biochemistry and Molecular Biology at Saint Louis University School of Medicine, St. Louis, MO. In 1992-1996, as a postdoctoral research fellow, he studied the pathophysiology of cholesterol gallstone formation, the physicalchemistry of lipids, and the molecular biochemistry of cholesterol and bile acid metabolism with Professor M.C. Carey at Harvard Medical School and Brigham and Women's Hospital, Boston, MA. At the same time, he studied the genetic mechanism of gallstone disease with Dr. B. Paigen at the Jackson Laboratory, Bar Harbor, ME. In 1996, he joined the faculty at Harvard Medical School, first as an Instructor of Medicine (1996-2000) and then an Assistant Professor of Medicine (2001-2010). Also, he worked as Gastroenterologist at Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (2000-2010). He joined Saint Louis University School of Medicine in 2011. Dr. Wang's major research interest is focused on the pathophysiology and genetics of cholesterol gallstone disease, and the molecular physiology and genetics of intestinal absorption of cholesterol and fatty acids, the physical-chemistry of cholesterol crystallization in bile, and the pathophysiology of cholestasis, nonalcoholic fatty liver disease, and the metabolic syndrome. His research has been supported by the NIH, foundations, and industry. Dr. Wang received the Industry Scholar Research Award from the American Digestive Health Foundation and American Gastroenterological Association (1996-1999) and the New Scholar Award from the Ellison Medical Foundation (1999-2003). He has published over 130 peer-reviewed papers.

Brent A. Neuschwander-Tetri, Saint Louis University School of MedicineDr. Neuschwander-Tetri is a Professor of Internal Medicine and the Director of the Division of Gastroenterology and Hepatology at Saint Louis University, St. Louis, MO. He completed his undergraduate studies at the University of Oregon and received his M.D. degree from Yale University. After internship and residency in internal medicine at the University of Wisconsin Madison, he completed his fellowship in gastroenterology and hepatology at University of California San Francisco. In 1991, he joined the faculty at Saint Louis University where he conducts clinical and basic research in nonalcoholic steatohepatitis. He is a participant in the NIDDK NASH Clinical Research Network which is conducting multicenter studies to understand the causes and identify treatments for NASH. He is actively involved in the teaching programs for the medical students, residents, and subspecialty residents, and he supervises the care of patients with advanced liver disease in inpatient and outpatient settings.

Piero Portincasa, University of Bari Medical SchoolDr. Piero Portincasa is a Professor of Internal Medicine at the University Medical School of Bari, Italy. In 1985-1987, as Research Fellow, he studied at Guy's Hospital, London, UK. In 1991, he settled as Assistant Professor at the University of Bari Medical School. In 1993-1995, he was an Internist at the University of Bari, he was Research Fellow and Staff Member at the Academic Hospital at the University in Utrecht, the Netherlands, where he completed his Ph.D. studies. In 2001, he was nominated Associate Professor of Internal Medicine at the University of Bari. In 2010, he was selected as Full Professor of Internal Medicine, at the national competition at the University of Bologna, Italy. He is an active member of several International Scientific Societies, and Journal Editorial Boards, Member of the Apulian Academy of Sciences (2009), President of the European Society for Clinical Investigation (ESCI: 2011-14), Honorary Visiting Professor at the University of Cluj-Napoca (Romania) (since 2009), Councilor of the Apulian Section of Italian Society Internal Medicine (SIMI) (2010-11), and Honorary Member of the Romanian Society Gastroenterology and Hepatology. He has been mentor and panelist in Ph.D. programs shared with the University of Utrecht (The Netherlands), Coimbra and Porto (Portugal), and Saint Louis (USA). He has been active in international relations, and since 2009, has been Faculty Delegate for the Erasmus/Long Life Learning Program for transeuropean mobility of teachers and students. Dr. Portincasa's major research interest is in the area of lipid metabolism and enterohepatic circulation with respect to mechanisms leading to cholelithiasis, fatty liver, and metabolic syndrome. He has been performing several translational studies focusing on transport of water and ions in the hepatointestinal tract, and gastrointestinal motility.